A very American death: how Caleb Blair lost his life in the Phoenix heat
Caleb Blair entered the Circle K gas station in Phoenix asking for help. “I can’t breathe, I’m hot, I need to sit down. I can’t breathe,” he told the male cashier. He was sweaty, panting heavily, and struggling to stand up straight.
It was 10 June 2022 in Phoenix, Arizona, and the city was experiencing the season’s first extreme heatwave. The temperature outside was 112F (44C) and rising.
The cashier told Caleb, a 19-yearold Black man, that he could not rest inside the air-conditioned store – it was against company policy. Blair had no choice but to go back outside, where CCTV footage shows him curled up on the asphalt, rolling around, distressed and struggling to breathe as cars drive in and out of the parking lot. The temperature on the unshaded ground was probably 130-140F (54-60C), but the teenager was unhoused and high on fentanyl, a powerful opioid, and methamphetamine, an addictive upper. He was confused, disorientated and overheating.
An hour or so later, a female Circle K employee called 911. “There’s a guy outside, he’s on something,” she said. “He’s banging his head against my car and he’s got blood on the door.”
By then, Caleb was naked and his breathing was worse. The temperature outside had climbed to 115F (46C).
Another 911 caller reported a man in “medical distress”. “I can see that his foot is cut, he just puked, it looks like it might be blood. He’s been doubled over hitting his head on the ground.” A third caller said: “He’s squatting down between cars, he’s obviously on something, beating the ground … it’s an African American male, he’s got a shoe in his mouth currently, pants around his ankles … he’s pulling his own hair.”
The first police car arrived at 2.56pm and an officer instructed Caleb to get down on the ground. Seconds later, body-camera footage shows Caleb sitting with his pants around his ankles, knees bent and hands outstretched behind him, in a sort of reverse bridge position. An officer can be heard describing Caleb as “pretty altered”, adding there was “no sign of a weapon”.
More police vehicles arrived on the scene. Caleb did a forward roll on the asphalt, jumped up, and officers grabbed his arms. “We don’t want any trouble, just trying to help you out,” one said.
Caleb was then handcuffed and dragged 25 metres to a shady mesquite tree with his pants still around his ankles. He was sitting bare-legged on the dusty ground covered in thorny leaves, the belt removed from his faded jeans. An officer repeatedly asked his name, but Caleb didn’t respond. The video shows that his breathing was shallow and he could not hold up his head. A couple of minutes later, the paramedics arrived and Caleb seemed unresponsive to light.
At 3.04pm, officers laid him flat on the ground, removed the handcuffs and pulled up his pants. He did not have a pulse, and at 3.07pm the paramedics started chest compressions. Caleb was dying. According to Phoenix police, he was transferred to a local hospital where he died from his injuries.
Over the course of eight months, the Guardian interviewed Caleb’s family and teachers, reviewed hours of police body-camera and audio evidence, CCTV footage and autopsy reports obtained through freedom of information requests, spoke to medical experts and visited places where Caleb had lived and died.
The medical examiner found that Caleb Blair’s death was caused by drug intoxication, with extreme heat and pneumonia identified as contributing factors. (The heat exhaustion or the drugs, maybe both, probably messed with Caleb’s gag reflex, causing him to inhale vomit, resulting in acute pneumonia.)
But after watching the video footage over and over again, Caleb’s father believes that his son died handcuffed on the dusty ground.
“My son took his last breath naked in handcuffs next to a dumpster,” says Frank Blair, 60. “He was clearly in medical distress but was rolling around outside in the heat before anyone called for help. He didn’t need handcuffs, he needed help. But this is the best a Black man can hope for – people don’t see us.”
Caleb’s death left one family to make sense of losing their sweet, funny boy, but in many ways this was a truly modern American death: the untimely passing of a Black teenager whose potential was cut short by drug addiction, mental illness, homelessness, police contact and the climate crisis.
It raises the question: was Caleb Blair’s death both preventable and inevitable?
•••
When he was a child in Denver, Colorado, one of Frank Blair’s jobs was making sure his younger siblings didn’t get hold of the drugs sold by his violent stepfather – or the pills their mother was addicted to. “Getting the little pills out of the car, and up from between the couch cushions so my siblings didn’t find them, that was my gig,” he says.
Frank left home when he was 12, and promised himself that his own kids
would never have to face those issues. He finished high school while living with his grandmother, but couldn’t afford college. Eventually, he started his own business as a contractor and often employed Black ex-prisoners.
In late 2011, Frank moved to Phoenix, Arizona, with his wife, Tywana, and their son Caleb, then nine, as well as two of Frank’s biological daughters, Maile and Kailani, aged eight and nine. (Frank had 12 children, and what he calls a “modern blended family”.)
Caleb’s mother, who declined to speak with the Guardian, had landed a management role with an energy utility, but the move was mostly about escaping what Frank describes as a campaign of racist harassment that landed him in jail and in hospital with severe depression. “If you think that the only way to harm a Black man is to kill him in the street, you’re missing the whole picture. I was a successful Black man giving other Black men a chance. That made me a threat and a target.”
In Phoenix, Frank opened a roadside recovery business and began trading on the stock markets. His new life felt like a fresh start.
His was a tough-love kind of household, but the siblings were close. “[Caleb] would clean our rooms, take the blame if we got in trouble. He was weird and smart and really sweet,” says Kailani, now 20. “He was always building stuff. He had too much energy – it was insane, he would be bouncing off the walls. [Looking back] I’m sure he had ADHD.”
•••
Kailani remembers the first time Caleb experimented with drugs. He was 11 or 12. He and a friend carved out an apple to smoke weed, and Caleb burned his nose while trying to light up. A year later, Kailani found dozens of bottles of over-the-counter cold medicine and cough syrup containing dextromethorphan (DXM) hidden in his room.
Half American adolescents have misused drugs at least once and fatal overdoses, which have more than doubled since 2019, are now the third leading cause of death among teens. Marijuana, nicotine and alcohol are the most common gateway drugs, but DXM, which in large quantities causes hallucinations and distorts reality, is popular among a significant minority of teens, according to Dr Neeraj Gandotra, chief medical officer at the Substance Abuse and Mental Health Administration (Samhsa).
DXM falls into the class of drugs known as dissociative hallucinogens, which includes ketamine and PCP. It’s illegal to sell DXM products to under 18s in some states, including Arizona, but it is popular partly because it’s so easy to steal or buy on the black market.
Kailani told her parents about Caleb’s secret stash of cough medicine bottles. He was grounded, and Frank warned him about the dangers of addiction. They even did random drug tests, but it didn’t stop him. Later, Frank found bottles buried in a box in the garden, along with pieces of aluminium and straws.
Kailani says that at first Caleb just wanted to fit in, to have fun and get high, but things got serious fast. One day, when Caleb was 14, Frank received a call from the principal’s office. Caleb had passed out from a suspected overdose of cough medicine, and an ambulance was on its way. This was not long after Frank had noticed cuts on Caleb’s forearms. He spent two weeks in an adolescent mental health unit, after which he and his parents went to a handful of counselling sessions. Frank and Kailani do not recall a diagnosis.
A few months later, Caleb overdosed again.
“He said the cutting made him feel better, that it calmed him down. Same with the drugs, he liked getting high and it helped slow down his mind. But he couldn’t explain the overdoses. It was a question I asked him many times,” says Frank, who hoped that extra chores and sports would help focus Caleb’s mind and keep him out of trouble.
Caleb was a talented football running back but mostly trained to keep his father happy and joke around with his teammates, according to his football coach, Shawn Kemmer. “The kid had a heart of gold. He would be the first to put his hand up offering to help out. The other kids gravitated towards him. He was highly intelligent, but his brain moved too fast … There was something painful that he couldn’t share, and he stopped showing up. I lost him.”
Caleb got into emo rap and started writing his own lyrics, and the death of his two favourite rappers – Lil Peep by suicide and XXXXTentacion by gunshot – hit him hard. Both were just 20. Soon after, Caleb met a girl in high school and together they started abusing Percocet, a prescription painkiller that contains an addictive opioid. At first it was one pill now and again, according to Kailani, but his consumption escalated after getting a part-time job in McDonald’s, which gave him enough money to buy his own regular supply. He was high – or low – all the time. What Kailani remembers most vividly is that he smelt of burning rubber, which came from smoking the Percocet pills.
On some nights, Frank was so scared to lose his son that he would zip-tie his own arm to Caleb’s so that he couldn’t sneak out. But after Caleb got hooked on fentanyl, there was little
Frank could do to stop him. He started flunking school and spent more and more time getting high with friends. To this day, Frank is torn about how he handled his son: “Sometimes I think I was too hard on him, sometimes that I should have been tougher,” he says.
Caleb stopped attending school halfway through his freshman year and moved in with his girlfriend’s family, working in fast-food joints and sometimes with Frank, but his drug use spiralled and it all fell apart. “He was sad all the time. For sure he was depressed, it runs in our family. At first he thought the drugs gave him something to rap about, but it took a hold of him,” says Kailani.
On his 17th birthday, Caleb was in a church-run rehab. On his 18th birthday, his parents kicked him out.
•••
Phoenix is America’s fifth-largest city – and the hottest. The number of perilously hot days and nights is rising thanks to global heating and unchecked urban development. It’s also a city plunged in an affordable housing crisis, where the number of folks sleeping in parks, on sidewalks, behind dumpsters, in parking lots and under bridges has exploded in the past few years.
Heat-related illness and deaths are preventable, but being unsheltered without adequate shade and water increases the risk of exposure and deadly medical complications.
In Maricopa county, where Phoenix is located, more than a thousand people have died from extreme heat in the past three years – about half of them unhoused. Heat exhaustion is characterised by symptoms such as heavy sweating, agitation, confusion, muscle cramps and weakness, and usually occurs when the body temperature hits 104F to 106F. (A normal body temperature is 97F to 99F). Without steps to cool the person down, exhaustion can lead to heatstroke, with shortness of breath, vomiting, delirium and loss of consciousness.
Rates of drug abuse – mostly meth and fentanyl – are also high among Phoenix’s homeless population, and play a role in about half the city’s heat deaths. Meth, a stimulant, can lead to shortness of breath, a rapid heartbeat, sweating and loss of consciousness – symptoms that mimic heat exhaustion and increase the risk of deadly heat exposure. Fentanyl, a synthetic addictive opioid between 50 and 200 times as potent as morphine, is a respiratory downer that can cause very shallow and slow breathing; users have died from heat exposure because they were too out of it to move into the shade.
Heat, homelessness and drug fatalities are not targeting people in the same measure. In the past decade, drug deaths have almost tripled in the US but have risen almost sevenfold among Black Americans, at least partially due to unequal access to treatment services. In Maricopa county, Black and Indigenous Americans have the highest rate of heat deaths.
Frank knew the risks Caleb faced on the street, and he spent hours every week tracking down his son, bringing him food and water, trying to persuade him to go back into rehab. His regular spots had shade and easy access to food, water and a bathroom, which also attracted dealers peddling meth and fentanyl for a few dollars a hit.
As Caleb’s addiction deepened, his physical state deteriorated. He lost a lot of weight, and his hands and feet were covered in bloody open sores. When Frank could intercept him, he would take Caleb home to shower, cool down, rehydrate and rest, but Caleb wasn’t ready to get clean, so they wouldn’t let him stay.
About 50% of Americans with a mental health diagnosis are not in treatment, while 90% of those with a substance use disorder are in the same boat: in trouble, without professional help. Caleb needed both. “The reasons people don’t enter care are varied and complicated. Payment, access and availability are a large part of it, but it also depends on the individual’s willingness – and families need help so they can help them,” said Gandotra.
In March, Caleb finally agreed to get help and was assessed at a mental health and addiction clinic, but according to Frank, the clinic wouldn’t admit him because he wasn’t suicidal. (The clinic wouldn’t comment on patient care.) He was given thrice-weekly outpatient appointments but didn’t go.
Another time, Frank brought him home and called the police, who took him to a psychiatric clinic. From there, he was transferred to a hospital with severe dehydration and skin infection, and then discharged himself, against psychiatric advice. He told Frank that he wasn’t ready. “He’d say ‘Dad, I’m gonna stop in July or August, I promise.’ But in my head I knew we weren’t gonna make it to August.”
By then, Caleb’s relationship with his mother had broken down completely, and the hours Frank spent tracking down his son were causing friction in their marriage. He was barely sleeping, and his children worried about the impact on his mental health.
Still, he couldn’t give up on Caleb. •••
In the final months of his life, Caleb often slept on a dusty waste ground behind a Family Dollar store, where he had pitched his tent alongside dozens of other unhoused people. A helper by nature, he had constructed a makeshift communal washroom using a tree and some tarpaulin.
On 10 May, he was in a bad way but still talking about quitting when Frank took him for Mexican food and gave him a new mobile phone. The next day Caleb, who had outstanding misdemeanours for petty theft, was arrested for having missed a court date. Caleb called Kailani and his dad from jail, asking them to pay the $100 bond. But they both felt relieved that he was off the streets and refused to help him get out, hoping that he would dry out.
Caleb was released four weeks later, on 8 June. His drug tolerance was probably lower, and the National Weather Service had issued the year’s first extreme heat advisory. Frank had intended to pick him up, but got caught up with work and didn’t go. Later he drove to Caleb’s regular spots, but couldn’t find him. “I knew he was vulnerable coming out of jail, but I kept working, and time just passed until it was too late. I dropped the ball.”
Kailani had arranged to take Caleb for dinner on the 9th, but he didn’t show up. “On our last call, he’d told me that he wanted to have some fun when he got out, but after that he was going to give it up, get his GED, get a job. He was tired of street life, said he wanted what I have,” says Kailani, who was living with her partner and pregnant at the time.
The following day, Kailani drove past the Circle K and saw a bunch of police vehicles and paramedics, but had no idea who was in trouble.
A few hours later, police officers knocked on Frank’s door.
“I never imagined that my sweet, funny little brother would end up a dead drug addict. I honestly thought he’d figure it out, stop being addicted and move on with his life,” Kailani says. “The homeless crackheads you walk past on the street, they are people like my brother. This can happen to anybody.”
We now know that at the hospital, after having spent several hours in the baking heat, Caleb’s temp was 109F. The paramedics’ thermometer maxes out at 108F, after which it simply reads “high”.
Six months later, Frank still spends several hours a week visiting Caleb’s old spots, unable to give up the grueling routine. Sometimes, he parks his truck next to the tree where Caleb lost consciousness. Caleb’s death makes no sense, and yet perfect sense. “This is a silent epidemic. I want people talking about it, so that something good comes out of it. I feel like a failure but I don’t want my son’s death to be for nothing. That’s how I’m dealing with my grief.”
rity – is important. “We are less happy when we struggle for food security and housing and all that, which is obvious,” he says. What is less obvious is that, above a certain income level, happiness doesn’t go up by much, at least according to a 2010 study that set the threshold for US households at $75,000 (£49,000 at that time). The enduring factor is relationships with other people. Waldinger has boiled down his definition of a good life to this: “Being engaged in activities I care about with people I care about.”
Waldinger, a professor of psychiatry at Harvard medical school and a practising psychiatrist, became director of the study in 2005; he is the fourth steward of the research, which began in 1938. Originally, there were two unrelated studies – one group of 268 students at Harvard, another of 456 boys from deprived areas of Boston – but they later merged. Over the years, whole lives have been recorded in real time: health, employment, details about friends and spouses, religious beliefs, how they voted, how they felt about the births of their children, what they worried about in the middle of the night. The list seems endless.
“I’m sort of a voyeur,” says Waldinger, beaming through my screen when we talk on a video call. “I’ve followed all these lives – you can take someone’s folder, thousands of pages, and you can flip through a life. Yes, we do a lot of sophisticated number crunching, but being able to read a life is pretty amazing.”
The study has its limits, he acknowledges. All the original participants were male (Waldinger introduced women by including their partners and children) and white, although this will change gradually as the more diverse third generation is brought in. For the book, he and Schulz include many other, more diverse, studies from around the world, but he stresses that they all show a similar pattern: the more socially connected you are, the more likely you are to live longer and live well.
Loneliness is now considered to be as bad for your health as smoking – and there is a loneliness epidemic. “The best hypothesis for which there’s good data is the idea that relationships help us manage stress,” says Waldinger. “We know that stress is a part of life. What we think happens is that relationships help our bodies manage and recover from stress. We believe that people who are lonely and socially isolated stay in a kind of chronic fight-or-flight mode where, at a low level, they have higher levels of circulating stress hormones like cortisol, higher levels of inflammation, and that those things gradually wear away different body systems.”
Can we really learn about happiness from white men, some incredibly privileged (John F Kennedy was a participant), born in the US in the 1930s? Yes, says Waldinger: “So much of this is about the basic human experience, which does not change.”
Waldinger subscribes to the theory that happiness falls into two categories. Hedonic wellbeing can be summed up as “am I having a good time right now?” he says. Then there is the Aristotelian idea of eudaimonic wellbeing: “That sense of life being meaningful and basically good.”
We don’t necessarily enjoy the things that contribute to eudaimonic wellbeing. The example Waldinger likes to give is having to read the same story to your child at bedtime when you are exhausted after a hard day. “Are you having fun? Is it hedonic wellbeing? No. But is reading that book for the seventh time the most meaningful thing you could do right then? Yes. Often, there’s this difference between what’s fun right now and what we are invested in.” Everyone needs a bit of both, he says. The problems tend to come from chasing only hedonic happiness, rather than the more mundane, but ultimately more meaningful, kind.
We are also not very good at knowing what will make us happy. It is partly cultural – we receive messages constantly that we will be happy if we buy something, or if we have more money, or if we succeed at work. “There was this really interesting survey where they asked millennials what they thought they were going to need to have a happy life, and fame was a really prevalent goal,” says Waldinger.
But it is also due to human nature. When researchers in one study asked people to talk to strangers on a train on their morning commute, those who had predicted it would be a negative experience discovered it was the opposite. “Talking to strangers is a little risky,” says Waldinger. “Even calling a friend is risky, because you don’t know whether your friend is going to want to hear from you. Human relations always have that element of unpredictability.” This is why staying in alone rather than going out can feel preferable. “If I stay home and watch something on Netflix, it’s a predictable evening for me. Part of it is this path of least resistance – away from relationships and towards something more predictable and manageable.”
Waldinger’s parents were from the same generation as the study’s first cohort. He had a happy childhood, although there were times when his mother, Miriam, didn’t seem content – she was a clever woman who was unfulfilled as a housewife. They lived in Des Moines, Iowa – “midwest, small town” – and the family was Jewish. Waldinger’s father, David, went to law school, but couldn’t get a job when he left. “That’s what life was like for Jewish professionals in the United States in the 1930s.” He went into business instead, but he didn’t love it; the lesson his son learned was to pursue work that was enjoyable and meaningful.
How aware was Waldinger of antisemitism as a child? “A bit,” he says. “We were not significantly discriminated against, but it was there.” It was under the surface, but in day-to-day life, he says, people were basically decent to each other. “That’s one of the things that’s so hard now, because the right wing in the US and around the world is taking the lid off some of these prejudices – racism, antisemitism – and that’s what I find so disheartening. It’s there to be tapped, it always has been, but in many times we’re able to keep the lid on it.”
He didn’t want to be a doctor; he wanted to be an actor and did drama alongside his academic studies. Before going to medical school, he came to the UK, where he had a fellowship at the University of Cambridge, and continued theatre. “I had such a good time, but I knew I wasn’t good enough to be a professional. I was too thin-skinned; I wouldn’t be able to take the rejections.” (Anyone who has watched Waldinger’s 2015 TedX Talk, which has had more than 44m views, will notice how that early theatre experience has translated into stage presence.) Once he became a doctor, though, he found that he loved psychiatry. “I was just fascinated by people’s lives and how their minds worked.”
He looks incredibly happy – and he says he is. “I’m in my early 70s and basically my health is OK. I’ve done my best to take care of myself, but that’s not the whole story. My happiness depends in part on luck, it depends in part on privilege. I have a partner and it’s a good partnership.” He and his wife, Jennifer, a clinical psychologist, have been married for nearly 37 years and have two grownup sons.
Waldinger is also a Zen master, having discovered the Buddhist practice in his 30s. He leads a weekly Zen group and does his own daily 25minute meditation. “My wife calls it my great big hobby,” he says. How important is religion or spirituality to happiness? The study has found that religious people are not more or less likely to be happy, but that they find faith a solace in times of stress.
He hasn’t always been happy, of course. The times he describes as less happy are characterised by disconnection from other people. As a smalltown boy who got a place at Harvard, he was miserable and lonely for at least his first year, until he made friends. Later, when his children were small, his parents died. “It was a really difficult time for a couple of years,” he says. “That was one of those life crunches. People go through those times and it can be really hard to sustain your happiness.”
It is unrealistic to be happy all the time, which sounds obvious, but the message has become that if you are not happy, you are not doing life right. Similarly, there is an idea that happiness is something you can achieve and then relax. “The good life is a complicated life for everybody,” says Waldinger. “We study thousands of lives. Nobody is happy all the time – no one person on the planet that I’ve ever encountered. The myth that you could be happy all the time if you just do all the right things is not true. Happiness waxes and wanes.”
Happiness “happens” to us, he says (assuming – and it is a big assumption at present – that your basic needs are met). “But there are things we can put in place in our lives that make us more likely to feel happiness more of the time.” Taking care of your health, diet, sleep and exercise are big ones: “If you are in better health, you are more likely to be happy.” But so is taking care of your relationships. “That’s partly because they help us with the flip side: they don’t just make us happy; they also help us weather the unhappy times, the challenges.”
In a world ravaged by Covid and economic crisis, we might feel that we are in particularly challenging times, but so did the first participants of the Harvard study, who had grown up in the Great Depression and, when the study started, were months away from the outbreak of the second world war (many participants fought in it).
“We asked them what got them through it and everybody said something about people. Soldiers said: ‘It was the people writing to me from home, and fellow soldiers.’ When people were asked about the Great Depression, it was the neighbours pulling together and sharing what limited resources they had,” says Waldinger.
“What we find is that if people maintain a network of good relationships, they’re more likely to weather the storms and they’re more likely to be happy.”
Every generation feels that the world is “going to hell”, he says, “but there are some unique things happening to us”. Economic inequality is rising. “It really matters. We know that collective wellbeing goes up when more people have their needs met.” There is increasing social disconnection. “Loneliness is on the rise, but also tribalism, and that is fuelled by the digital revolution.” The study is starting to ask questions about social media usage and its effect on wellbeing. “Other research is showing that, if we use social media actively to connect with each other, that’s more likely to enhance wellbeing. But if we passively consume, that often lowers our wellbeing.” The study has made him pay more attention to his own behaviour, he says. “I don’t just let my wife run our social life. I used to say: ‘Just tell me where to be.’ Now, I’m more careful about my own relationships and making sure that I keep them up.”
He describes it as “social fitness”: you don’t go to the gym once or twice and then assume your physical fitness has been addressed, he says. The same applies to friendships. “Good relationships wither away from neglect. There doesn’t have to be a problem of any kind, but if you don’t keep them up they fall out of your life. We find that the people who maintain vibrant social networks are the people who make an effort.” It doesn’t have to be big or timeconsuming – a regular text, a coffee, a walk. “These can be tiny actions, but if you do them repeatedly it keeps those networks vibrant.”
The quality of the relationship is important, regardless of who it is with – friend, partner, sibling, neighbour. “We asked people at one point: ‘Who could you call in the middle of the night if you were sick or scared?’ We believe that everybody needs at least one or two people like that,” says Waldinger. “If you don’t have that, you’re probably hurting.
“But then, beyond that, it really varies – a good relationship could be somebody you go to the pub with. Maybe you don’t talk about anything personal, but you don’t need to. Maybe you talk politics and it helps you feel connected and like you belong.”
Casual connections – a smile or a short conversation with the cashier in the supermarket or the bus driver – can also bring benefits. Ultimately, it comes down to connection and belonging. Join that club, don’t use the self-service checkout, text a friend and meet them, read that story again to your child – your health and happiness depend on it.
I can take someone’s folder, thousands of pages, and flip through a life